OATH / UNDERTAKING BY THE HOSTEL RESIDENT

I,_____________________________S/o Sh. _______________Roll No:________________Year__________

Branch__________________residing at Hostel _______________________Room No.: _________________

Do hereby undertake that:
1. I have read word-by-word the rules and regulations of the hostel, understood them thoroughly, shall remain
updated about them and shall abide by them fully.
2. I shall not indulge in any kind of quarrel/ fight/ theft and any other activity, including consuming liquor/
smoking in the hostel/ University premises. I shall also help the hostel administration by enrolling /
motivating other fellow residents into following the rules & regulations.
3. I shall not keep/ drive any two or four wheeler (motorized) vehicle in the hostel and University premises.
4. I shall not keep any costly / valuable item, heavy cash, etc. with me in the hostel and I understand that in
case of theft, the hostel/ University authority shall not be directly responsible except for the efforts that they
shall put in to set up some deterrence against such acts.
5. I shall maintain full dignity in my behavior. I will not create any loss/ damage to the hostel/ University and
I shall help in maintaining the hostel premises neat and clean.
6. I will not indulge in any form of ragging.
7. I understand that in case I do not abide by the rules and regulations of the Hostel/ University, strict
disciplinary action, including information to / calling my parents and expulsion from the hostel/ university
can be taken against me.

Photograph Photograph
of Father of Mother Signature of the student

We/I as a parent, has checked all particulars (especially the address & phone nos. of parents) filled by my ward.
We/I am aware of the following facts:
1. The DCRUST dispensary located in the campus in its community has limited facilities and is operable in
limited periods.
2. The DCRUST dispensary may not be adequate for the treatment of any patient with chronic or serious
ailments.
3. It is the responsibility of the parents/ guardians to take care of their wards for outside treatment.
Despite the best efforts on the part of the University, if any untoward event happens to my ward, I shall not
hold the University accountable for the same and will not seek any financial help or compensation for the
same from any court of law.
4. My ward is physically and mentally fit to stay in hostel.

Signature of Parents

Father Mother Guardian

Page 16 of 27
 DEENBANDHU CHHOTU RAM UNIVERSITY OF SCIENCE & TECHNOLOGY
MURTHAL-131039 (SONEPAT)
HOSTEL ADMISSION FORM (2023-24)
Hostel Name: _______________________________

1. Name of Student : _________________________

2. Category under which admitted: ________________________ Recent
3. Blood Group of Student : _________________________ Photograph of the
4. Adhaar Card No. : _________________________ student.
5. Date of Birth : _________________________
6. University Roll No. : _________________________
7. Discipline/ Department : _________________________
8. Student E-mail ID : _________________________
9. (a) Father’s Name : _______________________ __ (b) Mother’s Name : ____________________
10. Parents E-mail ID : _________________________
11. Permanent Address : ______________________________________________________________
_______________________________________________________________
Student’s Mobile No._____________ Father’s Mobile No.______________ Mother’s Mobile No. ________________
11. Correspondence Address : ______________________________________________________________
_________________________________________________________________________________________
Landline Phone No.____________________ Mobile No.____________ _ _______
12. Name & Address of local : ______________________________________________________________
Guardian (if any) ______________________________________________________________
Mobile No. of Guardian________________________Landline Phone No. of Guardian____________________
13. Distance from residence : _______________km(s)
Signature of the Student
14. Details of hostel accommodation, if any, for the immediate past session:
(a) Hostel Name: ________________________(b) Room No.:___________ _______
15. (a) Pending Dues: Rs.______________ (b) Disciplinary action taken, if any (For Ex-resident):___________ ____
_____________________________________________________________________________________________
(The columns (15 (a) & (b) be completed by previous Hostel Supervisor)

For Office Use Only

Certified that above mentioned student has cleared all Hostel & Mess dues (Rs………..) for the immediate past session &
any fines etc. on account of Disciplinary action taken, if any (for Ex-
resident):__________________________________________

Previous Hostel Supervisor / Warden

Mess security & Overhead establishment Charges:
Receipt No. Dated Amount

Student is allotted Room No. _______ on _________. Current Hostel Supervisor /Matron/
Warden

Page 18 of 27
 OATH / UNDERTAKING BY THE HOSTEL RESIDENT

Name ……………………………………………… Roll No. ………………………………. Branch………………………………

Hostel ……………………………………… Room No. …………………….
Permanent Address ………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………
….
Landline Phone No. (if any) .………………………Father’s Mobile No.………………………Mother’s Mobile No…....................
Correspondence Address…………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………..
Landline Phone No (if any) …………………………………. Student’s Mobile No.………………………………...
8. I have read word-by-word the rules and regulations of the hostel, understood them thoroughly, shall remain updated about
them and shall abide by them fully.
9. I shall not indulge in any kind of quarrel/ fight/ theft and any other activity including consuming liquor/ smoking in the hostel/
University premises. I shall also help the hostel administration by enrolling / motivating other fellow residents into following
the rules & regulations.
10. I shall not keep/ drive any two or four wheeler (motorized) vehicle in the hostel and University premises.
11. I shall not keep any costly / valuable item, heavy cash, etc. with me in the hostel and I understand that in case of theft, the
hostel/ University authority shall not be directly responsible except for efforts that they shall put in to set up some deterrence
against such acts.
12. I shall maintain full dignity in my behavior. I will not create any loss/ damage to the hostel/ University and I shall help in
maintaining the hostel premises neat and clean.
13. I will not indulge in any form of ragging.
14. I understand that in case I do not abide by the rules and regulations of the Hostel/ University, strict disciplinary action,
including information to / calling my parents and expulsion from hostel/ university can be taken against me.

Signature of
student
Photograph of Photograph of
Father Mother

I as a parent, has checked all particulars (especially the address & phone nos. of parents) filled by my ward.

Counter signature of Parent/

Guardian

Page 19 of 27
 ANNEXURE-I (Part –I)
AFFIDAVIT BY THE STUDENT
1. I, (Full name of the student with admission/ registration/ enrollment number) ……………………………………………...
S/O, D/O, Mr. / Mrs. / Ms. …………………………………………………., having been admitted to
…………………………………………………….., have received a copy of the UGC Regulations on curbing the
Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the ‘’Regulations”) carefully read
and fully understood the provisions contained in the said regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and
administrative action that is liable to be taken against me in case I am found guilty of abetting ragging activity or
passively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that
a. I will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the
Regulations.
b. I will not participate in or abet or propagate through any act of commission or omission that may be
constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that if found guilty of ragging, I am liable for punishment according to clause 9.1 of the Regulations,
without prejudice to any other criminal action that may be taken against me under any penal law for the time being
in force.
6. I hereby declared that I have not been expelled or debarred from admission in any institution in the country on
account of being part of a conspiracy to promote ragging, and further affirm that in case the declaration is found to
be untrue, I am aware that my admission is liable to be cancelled.

Declared this…………. day of …………… month of ………………… year.

_____________
Signature of deponent
Name:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and belief and no part of the affidavit is
false, and nothing has been concealed or mis-stated therein.

Verified at (place) on this the (day) of (month) , (year) .

_________________
Signature of deponent

Solemnly affirmed and signed in my presence on this (day)_______of (month),________(year) _______ after
reading the contents of this affidavit.

OATH COMMISSIONER

Page 20 of 27
 ANNEXURE-I (Part-II)
AFFIDAVIT BY PARENTS/ GUARDIAN
1. I, Mr. / Mrs. / Ms. ………………………………………………………………….. (full name of parents/ guardian)
Father/ mother/ guardian of…………………………………………………………………………………….(full name of
student with admission/ registration/ Enrollment number), have been admitted to ……………………………
……………(name of the university), have received a copy of the UGC Regulations on curbing the Menace of
Ragging in Higher Educational Institutions, 2009, (hereinafter called the” Regulations”) carefully read and fully
understood the provisions contained in the said regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and
administrative action that is liable to be taken against my ward in case he/ she is found guilty of abetting ragging
activity or passively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that
a. My ward will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the
Regulations.
b. My ward will not participate in or abet or propagate through any act of commission or omission that may
be constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against my ward under any penal law
for the time being in force.
6. I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country
on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging, and further affirm
that, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled.

Declared this…………. day of …………… month of ………………… year.

_____________
Signature of deponent
Name:
Address:
Ph. No.:
Landline No.:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and belief and no part of the affidavit is
false and nothing has been concealed or mis-stated therein.
Verified at (place) on this the (day) of (month), (year).

_________________
Signature of deponent

Solemnly affirmed and signed in my presence on this (day) of (month) ,(year) after reading the
contents of this affidavit.

OATH COMMISSIONER

Page 21 of 27
 HOSTEL IDENTITY CARD
Student’s recent
Name of the Hostel: ……………………………… photograph
Name of the Student: …………………………….
Room No. ………………………………………….
Enrollment / Roll No. ……………………………..
Branch ……………………………………………..

Checked & Issued by:

Hostel Supervisor signature with stamp & date.

Page 26 of 27